Differential Engagement with Experiential Techniques in Emotion-focused Therapy for Social Anxiety: A Two-case Series from an Indian University Setting

Social anxiety disorder (SAD) involves an intense fear of negative evaluation and avoidance of social situations. Emotion-focused therapy (EFT) is an emerging SAD treatment. Still, little is known about client differences in engagement with experiential EFT techniques and whether therapist-observed resistance to these techniques corresponds with therapeutic change. The present study describes a two-case series where two emerging adults with SAD from an Indian university setting received 10 weekly sessions of EFT for social anxiety (EFT-SA). A clinical psychologist diagnosed both participants using ICD-11 criteria alongside elevated Social Interaction Anxiety Scale scores. Participants completed standardized questionnaires measuring social anxiety, emotion regulation, interpersonal functioning, and self-compassion. Assessment was conducted at baseline, termination, and at 3- and 6-month follow-ups. Session-level clinical documentation of engagement and therapist-observed resistance to experiential tasks was also assessed. Both clients improved descriptively across measures; SIAS change was reliable only at 6 months, and scores stayed above clinical cutoffs. Notably, Client B, despite greater clinician-observed resistance to experiential techniques, showed larger gains in self-compassion. This discrepancy is consistent with process research showing that clinicians’ real-time impressions of resistance often did not correspond with treatment outcome. Clinically, this points to visible reluctance toward an experiential technique not being, on its own, a sign of global treatment disengagement, and suggests therapists may benefit from distinguishing reluctance toward a specific technique from broader disengagement from therapy. Findings are preliminary and descriptive, drawn from unstandardized clinician observations in two cases, and should be read as hypothesis-generating rather than as evidence of efficacy.